Individual
NICCOLE SWIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10773 W WHITEHORN WAY, PEORIA, AZ 85383-9802
(602) 301-4760
Mailing address
10773 W WHITEHORN WAY, PEORIA, AZ 85383-9802
(602) 301-4760
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-046621
AZ
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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